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付出就有回报:通过改进 CHG 沐浴,用数学模型和成本分析降低医院感染率。

You get back what you give: Decreased hospital infections with improvement in CHG bathing, a mathematical modeling and cost analysis.

机构信息

Department of Statistical Sciences and Operations Research, Virginia Commonwealth University, Richmond, VA; Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA.

Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA.

出版信息

Am J Infect Control. 2019 Dec;47(12):1471-1473. doi: 10.1016/j.ajic.2019.07.003. Epub 2019 Aug 7.

DOI:10.1016/j.ajic.2019.07.003
PMID:31400883
Abstract

BACKGROUND

Multiple studies have shown that bathing with chlorhexidine gluconate (CHG) wipes reduces hospital-acquired infections (HAIs). We employed a mathematical model to assess the impact of CHG patient bathing on central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and hospital-onset Clostridium difficile (C diff) infections and the associated costs.

METHODS

Using a Markov chain, we examined the effect of CHG bathing compliance on HAI outcomes and the associated costs. Using estimates from 2 different studies on CHG bathing effectiveness for CLABSI, CAUTI, and C diff, the number of HAIs per year were estimated along with associated costs. The simulations were conducted, assuming CHG bathing at varying compliance rates.

RESULTS

At 32% reduction in HAI incidence, increasing CHG bathing compliance from 60% to 90% results in 20 averted infections and $815,301.75 saved cost.

CONCLUSIONS

As CHG bathing compliance increases, yearly HAIs decrease, and the overall cost associated with the HAIs also decreases.

摘要

背景

多项研究表明,使用洗必泰葡萄糖酸盐(CHG)湿巾擦浴可降低医院获得性感染(HAI)。我们采用数学模型评估 CHG 患者擦浴对中心静脉相关血流感染(CLABSI)、导管相关尿路感染(CAUTI)和医院获得性艰难梭菌(C diff)感染的影响及其相关成本。

方法

我们使用马尔可夫链,研究 CHG 擦浴依从性对 HAI 结局和相关成本的影响。利用两项关于 CHG 擦浴对 CLABSI、CAUTI 和 C diff 有效性的研究中的估计值,估算每年 HAI 的发生次数及相关成本。假设 CHG 擦浴的依从率不同,进行模拟。

结果

在 HAI 发生率降低 32%的情况下,将 CHG 擦浴依从率从 60%提高到 90%,可避免 20 例感染,节省 815301.75 美元的成本。

结论

随着 CHG 擦浴依从率的提高,每年的 HAI 减少,HAI 相关总成本也随之降低。

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